Social Network Activation Among Adolescents Recently Discharged from a Psychiatric Hospital

Social network activation, or making use of social ties for support, is common during crises. Recent evidence indicates that network activation is common among people experiencing mental health crises and is positively associated with indicators of recovery. However, not all social networks function similarly. For example, network resources depend on the social status variables of members, with evidence suggesting that status is differentially associated with activation in times of need as well as the types of help accessed. Further, network activation may be partially dependent on perceived cause of mental illness as perceived cause may affect conceptualization and utilization of network resources. 

Our project examines social network activation among adolescents who recently experienced psychiatric hospitalization. Using survey and qualitative interview data, we examine how social network activation is associated with socioeconomic status, perceived cause of illness, and network characteristics.

Method

We limit our summary to the quantitative portion of our study. We used cross-sectional data from a sample of adolescents (n=102) recently discharged from a psychiatric hospital in a Midwestern city. Social network characteristics were measured using descriptions of five peer contacts (e.g. informing peers about hospitalization - defined as “activation”, perceived closeness, mental health of network members). Socioeconomic status was measured via report of parental education, and perceived cause of illness was measured using a 19-item scale that considered biological (e.g. chemical imbalance, α=.46), external (e.g. trauma, poverty, α=.72), or combination (e.g. relationship problems, α=.73) causal attributions. Associations were measured using descriptive statistics and multiple regression models.  

Results

Results showed that this sample of adolescents engaged in network activation, with over 80% telling at least one peer about their hospitalization and more than 50% informing all five peers. Not surprisingly, perceived closeness of peers and endorsement of mental health problems within the network were positively associated with activation.

Adolescents endorsed biological causes most strongly, though causal attributions were complex. For example, 50% of adolescents who endorsed genetic inheritance (n=40) also endorsed trauma as a “definite” cause, and a majority of those who reported a genetic cause did not define their mental health problems as stemming from a “biological illness”. On the whole, adherence to a biological cause was positively associated with network activation as well as knowing peers involved in mental health treatment.

This sample of adolescents reported high levels of parental education, with 30% reporting both mother and father had graduated from college. Parental education was not reliably associated with activation or perceived cause of illness, with one exception: paternal education was negatively associated with adolescent endorsement of external cause. This association remained robust across models controlling for other characteristics.

Conclusion

Social network activation is common among adolescents experiencing psychiatric crises. Evidence suggests activation is more likely among adolescents who endorse particular illness cause beliefs and that causal attributions are associated with status and network characteristics. These findings underscore the need to document adolescents’ nuanced understanding of mental health as well as its connection to network activation, particularly when social networks are implicated in intervention.